Sexual assault and adults with a disability

Enabling recognition, disclosure and a just response

Suellen Murray and Anastasia Powell

Contents

Introduction1

Prevalence of sexual assault of adults with disabilities2

Who are the offenders in cases of sexual assault

of women with disabilities?4

Barriers to disclosure to sexual assault of adults

with a disability5

Enabling disclosure and an appropriate response7

Enabling an appropriate response to sexual assault

of people with a disability post-disclosure8

Conclusion15

Acknowledgements17

References17

Adults with a disability can face particular barriers to disclosure of sexual assault and the responses to those who disclose are often inadequate. Enabling disclosure and providing the most appropriate responses across public policy, the criminal justice system and the service sector require further and urgent attention. This issues paper, drawing on international literature as well as consultations with staff of a number of Australian programs, provides clear directions for future research and practice in responding to and preventing sexual assault among adults with a disability.

Introduction

Adults with physical, intellectual or psychiatric disabilities face particular risks of sexual assault and exploitation. Research consistently finds that rates of sexual assault of people with a disability are much higher than the general population. In addition, victims of sexual assault face particular barriers to making a disclosure. If a disclosure is made, responses to this disclosure are often inadequate and may be harmful. A response to the sexual assault of an adult with a disability that is adequate is unfortunately still very rare, making addressing this issue a matter of continued urgency.

The Australian Bureau of Statistics (ABS, 2003) Survey of Disability, Ageing and Carers states that one in five Australians reports a disability. The most common form of disability reported is physical disability (14.7%), which places limitations on the extent and range of movement or activity (Australian Institute of Health and Welfare [AIHW], 2006). Individuals with a psychiatric disability[1] comprise 2.2%, sensory or speech disability 2.1%, and an intellectual disability 0.8%. It should also be noted that 6.3% of the population have a profound or severe core activity restriction, with women experiencing a higher rate at 7.1% of the female population as compared with 5.5% for men (ABS, 2003). Recognising that adults with a disability are not a homogenous group, but rather represent a diverse range of abilities and potential vulnerabilities, is particularly important. Indeed adults with a disability may not all experience the same risk or vulnerability to sexual assault, and nor will the issues and barriers that they face be the same.

“Disability” is a contested term for which the meaning is socially situated, such that the conditions or diverse abilities included in formal definitions of disability can vary between societies and over time. Using a social model of disability, it can be understood as “the result of disabling social, environmental and attitudinal barriers” (Howe, 1999, p. 12). Therefore, it is the societal perceptions and responses to people with a disability that are more often responsible for the increased risk of victimisation that such individuals experience. Consequently, certain factors place people with disabilities at risk of sexual violence. These factors include social and physical isolation, dependence on carers, a lack of knowledge that violence is criminal, and communication difficulties (Goodfellow & Camilleri, 2003; Petersilia, 2001; Women with Disabilities Australia, 2007a). As noted by the Victorian Women with Disabilities Network:

Women with disabilities who experience violence find they have less information about what constitutes violence; experience high levels of social isolation and increased dependence on a perpetrator; they are often not believed when reporting; they have greater difficulty accessing support services and may experience lower self-esteem that results in “tolerating violence”. (2007, p. 8)

This paper reviews current knowledge regarding the prevalence of sexual assault of adults with a disability, who the offenders are, and particular barriers to disclosure. It discusses the ways that individuals, organisations and society can enable the disclosure of sexual assault of people with a disability. The paper then considers the most appropriate responses post-disclosure, in terms of public policy, the service sector and the criminal justice system. Finally, good practice examples in responding to and preventing the sexual assault of people with a disability are profiled and directions for future research and practice considered.

Prevalence of sexual assault of adults with disabilities

Sexual assault within disability and age care residential settings ... is a fact. These assaults occur for a variety of very complex reasons including the vulnerability of the residents, a service culture of secrecy and hidden violence, disbelief that such vulnerable people would be victims of sexual assault and services’ lack of understanding of appropriate preventive measures. (Sexual Assault in Disability and Aged Care Action Strategy, 2007)

Despite being the major national data collection regarding the status and experiences of adults with a disability, the ABS Survey of Disability, Ageing and Carers, does not invite participants to report on their experiences of violence or abuse. Similarly, the ABS (2006) Personal Safety Survey report, which specifically investigates experiences of violence, does not identify the disability status of participants, and the International Violence Against Women Survey (IVAWS) specifically excluded women with an illness or disability from the sample for the survey[2] (Mouzos & Makkai, 2004). Therefore, despite evidence that approximately 20% of Australian women, and 6% of men, will experience sexual violence in their lifetime (ABS, 2006), there is no standard national data collection that includes the experiences of sexual violence amongst adults with a disability, or more specifically, the experiences of women with a disability.

Reported crime data, collated by each state and territory, similarly provide an inadequate estimate of the prevalence of sexual violence experienced by adults with a disability. In addition to sexual assault already widely acknowledged as an under-reported crime, police recording of disability status among reported sexual offences is often incomplete and in many cases based on an individual police officer’s subjective observations (Heenan & Murray, 2007; Cook, David & Grant, 2001). Nonetheless, a recent study of Victoria Police data regarding sexual assault indicates that just over a quarter of all victims were identified as having a disability. Of this group, 130 (15.6%) had a psychiatric disability or mental health issue and 49 (5.9%) had an intellectual disability (Heenan & Murray, 2007). These data indicate that adults with a psychiatric and/or intellectual disability in particular are over-represented as victims of reported sexual assault, representing just 2.2% and 0.8% of the Australian population generally (AIHW, 2006). There is also no consistent or standardised recording of allegations or incidents of sexual abuse of people with a disability across sexual assault victim services, the disability sector and other relevant agencies (Women with Disabilities Australia, 2007a; French, 2007; Heenan & Murray, 2007; Victorian Law Reform Commission, 2004; Cook, David & Grant, 2001). The need for improved data collection by key agencies has been noted elsewhere (e.g., Heenan & Murray, 2007; Victorian Law Reform Commission, 2003). Additional barriers also prevent disclosure and reporting of sexual violence by adults with disability, and these are discussed in a later section.

While these issues in the reporting and recording of sexual assault of adults with a disability make establishing the prevalence of victimisation difficult, there are some research studies that provide additional estimates. Several studies in the United States and Canada indicate that women with a range of disabilities - including physical, language or intellectual impairments - are far more likely to experience sexual assault than women without disabilities (Brownlie, Jabbar, Beitchman, Vida, & Atkinson, 2007; Brownridge, 2006; Martin et al., 2006), and tend to experience all forms of abuse for significantly longer periods of time (Nosek, Howland, Rintala, Young, & Changpong, 2001). A highly cited Australian study conducted in 1989 surveyed a sample of 158 adults with an intellectual disability in South Australia using questions adapted from the 1983 ABS Victims of Crime Survey (Wilson, 1990; Wilson & Brewer, 1992). The study found that adults with an intellectual disability were more than twice as likely to be victims of personal crimes as the general adult population, and 10.7 times more likely to be victims of sexual assault in particular (Wilson & Brewer, 1992). Furthermore, the likelihood of victimisation differed according to an individual’s living arrangements, such that those people with an intellectual disability that lived in shared residential care or institutional settings were most vulnerable to abuse. A further key finding of the study is that when victimised, adults with intellectual disability are unlikely to report the crime to police themselves, with a third party such as a family member or carer often doing so. Where the person experiencing abuse is dependent on a carer who is perpetrating abuse, the capacity to report is severely restricted. Wilson and Brewer (1992) found that between 40 and 70% of crimes go unreported, and that sexual assault in particular is least likely to be reported to police. The finding that adults with an intellectual disability are significantly less likely to report a crime themselves also highlights the additional vulnerability of this group to crime victimisation, such that in residential facilities in particular it is most often “staff, rather than the victim who decide when police intervention is called for” (Wilson, 1990, p. 9). As stated at the outset of this section, it is important to recognise that adults with disabilities are a diverse group, and that the diversity of disability translates into a diversity of experiences of violence and differing risk of sexual assault. A repeat of this, or a similar, survey with a more representative sample of the diverse Australian population of adults with a disability has yet to be undertaken, and would represent an important step in national data collection regarding sexual violence.

Existing data also indicates that adult men and women with a disability do not experience equivalent risk of victimisation of sexual violence.[3] Consistent with patterns of sexual assault generally, there is a gendered aspect to sexual violence that is perpetrated against adults with a disability. Australian and international research indicates that it is predominantly women with a disability who continue to be the victims (Brownlie et al., 2007; French, 2007; Women with Disabilities Australia, 2007a,b). The gendered pattern of sexual violence persists across diverse abilities and indeed across the lifespan. The aforementioned study by Heenan & Murray (2007) found nine sexual assault victims, all female, who were aged 60 years or over at the time of the sexual assault, of these, six were identified as having a physical, cognitive or psychiatric disability and three assaults occurred in residential facilities, indicating a cross-over between the vulnerability of women with a disability and women in residential aged care settings.

While women remain overwhelmingly the victims of sexual violence, men with an intellectual disability do experience greater risk of victimisation than men in the general population (French, 2007; Heenan & Murray, 2007; Sobsey, 1994), a trend which does not appear to hold across all men who have a disability. Therefore, in addition to gender, these prevalence patterns suggest that increased risk of sexual victimisation may be more closely linked with vulnerability, such that those adults with the greatest care or support needs are also most likely to experience sexual violence. Consistent with the national and international literature, the remainder of this paper will largely focus on women with intellectual disabilities, complex communication disabilities,[4] or psychiatric disabilities, as these are the women who are most vulnerable to sexual assault. However it is acknowledged that the issues raised in this paper and the good practice examples identified may also be relevant for women with other diverse abilities and complex needs.

Who are the offenders in cases of sexual assault of women with disabilities?

The national and international literature identifies three main perpetrator groups of sexual violence against women with disabilities, and again it is consistent with broader patterns of sexual assault, in that it is known-men, rather than strangers, who are the predominant offenders (Brownlie et al, 2007; Heenan & Murray, 2007; French, 2007; Women with Disabilities Australia, 2007a,b).

Firstly, for women with intellectual disabilities living in residential settings, male residents are frequently identified in the literature as the most common perpetrators of sexual abuse (People with Disability, 2007; Community Services Commission & Intellectual Disability Rights Service, 2001; Wilson & Brewer, 1992; Wilson, 1990). In such settings, the abusive behaviour may be minimised because it is deemed to part of the offender’s disability to behave inappropriately (Attard, 2007; Worth, 2008).

Secondly, family members - who may also perform carer responsibilities - are commonly identified as a key perpetrator group and can include the intimate partner or ex-partner of a woman with a disability (McFarlane et al., 2001; Wilson & Brewer, 1992; Wilson, 1990) or alternatively a father or step-father (McCarthy, 1998). Indeed, the interface of sexual violence and domestic or family violence remains largely under-acknowledged in the research literature. This is despite international research suggesting that, across a range of disabilities, women are at greater risk of experiencing various controlling behaviours as well as verbal and physical abuse (Women with Disabilities Australia, 2007a,b; Brownridge, 2006; Nosek et a., 2001). Paid in-home carers are also a potential offender group, although again, this is not widely acknowledged in the research literature. There are additional barriers to disclosure for women with a disability who experience abuse from a family member or in-home carer, which may contribute to less awareness of this issue, and these are discussed in the following section. However, there are moves to provide greater protection to adults with a disability who experience abuse in the home (whether from a family member or other carer), with the expansion of family violence legislation to include this relationship in both Queensland (Domestic and Family Violence Protection Act 1989, s.12B.4.a.b) and New South Wales (Crimes Act 1900, s.562A.3.e), with similar legislation proposed in Victoria (see Family Violence Bill2007, s.12).

Staff in residential care facilities or disability support services represent a third frequently identified perpetrator group (Community Services Commission & Intellectual Disability Rights Service, 2001; Sobsey, 1994). These can include direct care staff as well as other more peripheral staff, including disability transport providers (for instance, some qualitative research also identifies taxi or other transport drivers as perpetrators, see Community Services Commission & Intellectual Disability Rights Service, 2001; Wilson & Brewer, 1992; Wilson, 1990). Perpetrators of sexual violence who work in care-providing roles can maintain ongoing access to potential victims, selecting those women who are least able to resist or make a formal complaint. Speaking at the 2nd National Ageing & Disability Conference, Lauren Kelly and Julie Blyth of the Northern Sydney Sexual Assault Service, described their experience responding to this issue:

Offenders will often move from facility to facility. When suspicions arise in one place, they move on. We were contacted recently about an offender who has now sexually assaulted in at least three different facilities. However because he hasn’t been formally charged he is still working with an agency which provides locums to disability and aged care services. He always targets clients with little or no verbal communication. (Kelly & Blyth, 2005, p. 2)

Barriers to disclosure to sexual assault of adults with a disability

There are significant barriers to disclosure of sexual assault by people with a disability and these barriers may operate at societal, organisational and individual levels that, to some extent, overlap and interact. There are also different levels of disclosure of sexual assault, for example, disclosure to a family member or to staff at a residential unit, and also disclosure (or reporting) to police. As noted, due to the nature of some disabilities and organisational policies, typically, reporting to police occurs by a person other than the victim.

At the societal level, barriers to disclosure are related to wider understandings of sexual violence. If the perpetration of sexual violence is considered acceptable (or at least in some circumstances - and given the high levels of sexual violence that women experience it must be assumed that some people consider this to be so), then people with disabilities may also believe that it is acceptable behaviour and that it is not something to be disclosed. Alternatively, sexual violence may be experienced as shameful and, like others, people with disabilities may be deterred from disclosure because of their feelings of shame and stigma associated with the assault.

Moreover, and more particularly, how “disability” and “vulnerability” are understood may be reflected in the responses of those to whom the disclosure would be made and may also result in creating barriers to disclosure. For example, a woman with disabilities may be concerned that she will not be believed because of ideas that people with disability are asexual (or promiscuous), that they lie or exaggerate, or would not be sexually assaulted (Chenoweth, 1996; Lievore, 2005; Women with Disabilities Australia, 2007b). In relation to disclosure to police by people with intellectual disabilities, Keilty & Connelly (2001) found that “two myths, in particular, emerged consistently: women with intellectual disability are promiscuous and the complainant’s story is not a credible account” (p. 280). Police, in particular, may appear dismissive of allegations of sexual assault as the victim may be perceived as someone who could be too readily influenced and hence make a poor witness (Phillips, 1996; Victorian Law Reform Commission, 2003; Victorian Law Reform Commission, 2004).

These negative responses may be expressed as disbelief, ridicule, blame, rejection or persecution (Davidson, 1997). Due to these responses, she may be concerned that nothing will happen when she does disclose, that something may happen that she does not want to happen, or indeed, that the situation is made worse or it is taken out of her hands. As noted by Cockram (2003) in relation to women with disabilities who experienced domestic violence:

The responses of others to some of the women’s eventual disclosure was often significant in determining the women’s subsequent help-seeking behaviour. At worst, a poor negative response deterred or delayed the women from seeking help from elsewhere. (p. 43)